Organization
EYE CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS WILLIM VEITH M.D. (PRESIDENT)
(262) 248-8577
Entity
Organization
Contact information
Practice address
7363 STATE ROAD 50, LAKE GENEVA, WI 53147-4516
(262) 248-8577
(262) 248-8757
Mailing address
7363 STATE ROAD 50, LAKE GENEVA, WI 53147-4516
(262) 248-8577
(262) 248-8757
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
18321
WI
Other
Enumeration date
01/21/2008
Last updated
01/21/2008
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